ABSTRACT This R03 application will serve as the foundation by which the PI will build a line of research dedicated to the area of family based approaches to colorectal cancer (CRC) prevention and control. Cancer is a shared experience, affecting both the patient and the family members. While researchers have examined the effects of cancer on the family system, very few studies have examined the effects of the cancer experience on family members'cancer prevention behaviors. Family history is a significant risk factor for almost all cancers and individuals with a family history of cancer may be spurred to engage in cancer prevention behaviors to decrease their personal risk of cancer or for other reasons not yet understood. A diagnosis of cancer may therefore serve as a teachable moment for families, motivating them to engage in cancer-related health behavior change, either individually or collectively. A better understanding of the familial/social determinants of cancer prevention behavior is needed to further advance the field and could open the "black box" of the teachable moment concept to better understand how cancer, experienced directly or indirectly, might stimulate adoption of cancer prevention behaviors. The objective of this R03 application is to bring the family to the foreground by exploring the meaning of the family cancer experience and its relationship to cancer prevention behavior. This study will fill important gaps in our understanding of familial determinants of cancer prevention behavior and potentially affect the more than 11 million estimated cancer survivors and their families. We will focus on families with colorectal cancer (CRC) meeting the familial risk criteria, but with no known genetic syndromes. The Mayo Clinic Biobank for Gastrointestinal Health Research (BGHR) will be used to identify and recruit 24 families (72-102 individuals) for individual in-depth interviews with cancer patients and their family members using an approach primarily consistent with grounded theory. Our aims are to: 1) describe the cancer experience and how it has affected the behaviors of the family and its individual members, especially in the context of cancer prevention;2) assess receptivity to and preferences for family-based cancer prevention interventions;and 3) explore potential ethical/privacy concerns with regard to the recruitment, design, and evaluation of a family-based cancer prevention intervention. PUBLIC HEALTH RELEVANCE: This study will explore the meaning of the family cancer experience and its relationship to cancer prevention behavior by conducting individual in-depth interviews with 24 cancer patients and their family members. Findings from this study will be used to develop family-based approaches to cancer prevention and control.